Effective Leadership and Management in Nursing

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  • Edition: 7th
  • Format: Paperback
  • Copyright: 2009-01-01
  • Publisher: Prentice Hall
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Used worldwide, this award-winning book has been revised to reflect many changes in nursing and health care. Targeted to students, practicing nurses, and those in management, this book helps all nurses acquire skills they need to be successful in today's dynamic health environment. FEATURES: NEW-added chapters on retention of nurses and workplace violence prevention NEW-expanded technology content, especially networking among information systems and linking clinical data with information systems NEW-expanded community and public health content NEW-Questions to Challenge You at the end of each chapter NEW-list of tools for using the skills presented in the chapter NEW-Case Studies with Manager's Checklist that show concepts in action

Table of Contents

Understanding Nursing Management and Organizationsp. 1
Introduction to Nursing Managementp. 2
The Changing Health Care Systemp. 3
Cost Containmentp. 3
Quality and Outcomesp. 4
Rural Health Carep. 4
Cultural Diversityp. 5
Changes in Nursingp. 5
Challenges for Nurse Managersp. 6
Organizational Theory and Designp. 8
Organizational Theoriesp. 9
Classical Theoryp. 9
Neoclassical Theoryp. 11
Systems Theoryp. 11
Contingency Theoryp. 12
Chaos Theoryp. 13
Health Care Organizationsp. 13
Types of Health Care Organizationsp. 13
Interorganizational Relationshipsp. 16
Diversificationp. 16
Organizational Structurep. 17
Functional Structurep. 17
Service-Integrated Structurep. 18
Hybrid Structurep. 19
Matrix Structurep. 19
Parallel Structurep. 20
Shared Governancep. 20
Self-Organizing Structuresp. 22
Redesigning, Restructuring, and Reengineeringp. 22
Strategic Planningp. 24
Valuesp. 25
Visionp. 25
Missionp. 25
Philosophyp. 25
Goalsp. 25
Organizational Environment and Culturep. 25
Nursing Care Delivery Systemsp. 29
Types of Nursing Care Delivery Systemsp. 30
Functional Nursingp. 31
Team Nursingp. 31
Total Patient Carep. 33
Primary Nursingp. 33
Practice Partnershipsp. 34
Case Managementp. 34
Differentiated Practicep. 38
Patient-Centered Carep. 39
Leading and Managingp. 41
Leaders and Managersp. 42
Leadershipp. 42
Power: How Managers and Leaders Get Things Donep. 43
Leadership Theoriesp. 47
Trait Theoriesp. 47
Behavioral Theoriesp. 47
Contingency Theoriesp. 50
Contemporary Theoriesp. 56
Management Functionsp. 58
Classical Descriptionp. 58
Mintzberg's Behavioral Descriptionp. 60
A Contemporary Model of Managerial Workp. 61
Roles and Functions of Nursing Managersp. 62
Levels of Managementp. 63
First-Level Managementp. 63
Middle-Level Managementp. 65
Upper-Level Managementp. 66
Charge Nursep. 67
Staff Nursep. 67
Legal and Ethical Issuesp. 70
Laws and Ethicsp. 71
Ethical Decision Makingp. 72
Ethical Theoriesp. 72
Ethical Principlesp. 72
The Legal Systemp. 73
Sources of Lawp. 73
Types of Lawp. 74
Tort Lawp. 75
Liabilityp. 75
Legal Issues in Nursingp. 76
Nursing Licensurep. 76
Patient Care Issuesp. 77
Management Issuesp. 79
Employment Issuesp. 83
Power and Politicsp. 88
Politics: The Art of Influencingp. 89
A Framework for Political Actionp. 90
Politics in the Workplacep. 90
Politics in Governmentp. 91
Politics in Financingp. 91
Politics in the Organizationp. 91
Politics in the Communityp. 92
Power and Leadershipp. 93
Image as Powerp. 93
Using Power to Increase your Professional Influencep. 95
Why Power?p. 95
Power plus Visionp. 96
Applying Power and Politics to Managing Nursing Carep. 97
How Nursing's Voice Can Become Powerfulp. 97
The Impact of Power and Politics on Nursing's Futurep. 99
Key Skills in Nursing Managementp. 101
Budgeting and Resource Allocationp. 103
The Budgeting Processp. 104
Approaches to Budgetingp. 105
Incremental Budgetp. 105
Zero-Based Budgetp. 106
Fixed or Variable Budgetsp. 106
The Operating Budgetp. 106
The Revenue Budgetp. 106
The Expense Budgetp. 107
Determining the Salary (Personnel) Budgetp. 108
Benefitsp. 108
Shift Differentialsp. 108
Overtimep. 109
On-Call Hoursp. 110
Bonuses and Premiumsp. 110
Salary Increasesp. 110
Final Considerationsp. 110
Managing the Supply and Nonsalary Expense Budgetp. 110
Developing the Capital Budgetp. 111
Timetable for the Budgeting Processp. 111
Monitoring Budgetary Performance during the Yearp. 111
Variance Analysisp. 113
Position Controlp. 115
Staff Impact on Budgetary Performancep. 115
Future Trendsp. 115
Effectiveness, Efficiency, and Productivityp. 117
What Are Effectiveness, Efficiency, and Productivity in Health Care?p. 118
Organizational Effectiveness in Health Care Todayp. 118
Health Care Inputsp. 119
Health Care Outputsp. 119
Output or Outcome?p. 121
Effectivenessp. 121
Efficiencyp. 121
What Is Nursing Productivity?p. 122
Measuring Nursing Productivityp. 122
Resources per Patient Dayp. 122
Utilization Ratesp. 123
Improving Nursing Effectiveness, Efficiency, and Productivityp. 125
Changes in Use of Inputsp. 126
Changes in the Process of Carep. 126
Quality Managementp. 133
History of Quality Managementp. 134
Total Quality Management (TQM)p. 135
TQM Characteristicsp. 137
Continuous Quality Improvement (CQI)p. 138
Comprehensive Components of Quality Managementp. 140
CQI--How It Works: A Practical Examplep. 142
Risk Managementp. 143
A Risk Management Programp. 143
Nursing's Role in Risk Managementp. 144
Examples of Riskp. 144
Role of the Nurse Managerp. 146
Key Behaviors for Handling Complaintsp. 147
A Caring Attitudep. 147
Evaluation of Risk Managementp. 148
Problem Solving and Decision Makingp. 150
Critical Thinkingp. 151
Problem Solvingp. 152
Problem-Solving Methodsp. 152
The Problem-Solving Processp. 154
Group Problem Solvingp. 157
Decision Makingp. 159
Types of Decisionsp. 160
Decision-Making Conditionsp. 160
The Decision-Making Processp. 162
Decision-Making Techniquesp. 163
Group Decision Makingp. 164
Stumbling Blocksp. 167
Creativity in Decision Makingp. 168
Characteristics of Creative Personsp. 168
Managing Creativity in Health Care Settingsp. 169
Communication and Conflictp. 172
Communicationp. 173
Modes of Communicationp. 173
Directions of Communicationp. 174
Factors Influencing Communicationp. 175
Assertivenessp. 178
The Role of Communication in Leadershipp. 179
Communicating with Different Populationsp. 179
Subordinatesp. 179
Superiorsp. 180
Peersp. 182
Medical Staffp. 182
Other Health Care Personnelp. 184
Patients and Familiesp. 184
Difficult Peoplep. 184
Conflictp. 185
Conflict Process Modelp. 186
Conflict Managementp. 188
Goals of Conflict Managementp. 189
Conflict Management Modesp. 191
Other Conflict Management Techniquesp. 191
Using Management Information Systemsp. 195
Information Systemsp. 196
Management Information Systemsp. 196
Hospital Information Systemsp. 196
Expert Nursing Information Systemsp. 196
Benefits of Using Information Systemsp. 196
Obstacles Associated with Information Systemsp. 197
Computer Applications in Nursingp. 198
Patient-Care Applicationsp. 198
Nursing Management Systemsp. 199
Communication Systemsp. 199
Educational Applicationsp. 201
Research Applicationsp. 201
Software Selection and System Implementationp. 201
Selecting a System: The Decision-Making Processp. 201
Ethical and Social Considerationsp. 203
The Nurse Informatics Specialistp. 203
Future Trends in Informaticsp. 204
Stress and Time Managementp. 206
The Nature of Stressp. 207
Causes of Stressp. 208
Role Conflict and Role Ambiguityp. 210
Consequences of Stressp. 211
Managing Stressp. 211
Personal Methodsp. 211
Organizational Methodsp. 212
Time Managementp. 213
Goal Settingp. 213
Delegationp. 214
Time Analysisp. 214
Setting Prioritiesp. 215
Daily Planning and Schedulingp. 216
Grouping Activities and Minimizing Routine Workp. 216
Implementationp. 216
Personal Organization and Self-Disciplinep. 216
Controlling Interruptionsp. 217
Paperworkp. 218
Respecting Timep. 219
Effective Delegationp. 221
Defining Delegationp. 222
Responsibility and Accountabilityp. 222
Authorityp. 223
Differentiating Delegation from Work Allocationp. 224
Benefits of Delegationp. 224
Benefits to the Delegatorp. 224
Benefits to the Delegatep. 224
Benefits to the Organizationp. 224
Benefits to the Patientp. 224
The Delegation Processp. 224
Identifying and Defining the Task and Level of Delegationp. 224
Determining Whop. 226
Describing Expectationsp. 227
Reaching Agreementp. 227
Monitoring Performance and Providing Feedbackp. 227
Accepting Delegationp. 227
Obstacles to Delegationp. 228
A Nonsupportive Environmentp. 228
An Insecure Delegatorp. 228
An Unwilling Delegatep. 231
Ineffective Delegationp. 231
Underdelegationp. 231
Reverse Delegationp. 231
Overdelegationp. 231
Liability and Delegationp. 231
Building and Managing Teamsp. 233
Differentiating Groups from Teamsp. 234
Group and Team Processesp. 236
Phases of Group and Team Developmentp. 236
Team-Buildingp. 238
Characteristics of Groupsp. 239
Normsp. 239
Rolesp. 240
Communication in Groupsp. 241
How Groups Affect Individualsp. 241
The Nurse Manager as Team Leaderp. 242
Group Taskp. 243
Group Size and Compositionp. 243
Managing Committees and Task Forcesp. 243
Guidelines for Conducting Meetingsp. 244
Managing Task Forcesp. 245
Patient Care Conferencesp. 246
Initiating and Managing Changep. 248
Nurse as Change Agentp. 249
Nurse as Entrepreneurp. 249
The Process of Changep. 250
Change Theoriesp. 250
Lewin's Force-Field Modelp. 250
Lippitt's Phases of Changep. 250
Havelock's Modelp. 252
Rogers' Diffusion of Innovationsp. 252
Using Change Theories in Nursingp. 252
Planning Changep. 252
Assessmentp. 254
Planningp. 255
Implementationp. 255
Evaluationp. 256
Change Agent Strategiesp. 256
Power-Coercive Strategiesp. 257
Empirical-Rational Modelp. 257
Normative-Reeducative Strategiesp. 257
Change Agent Skillsp. 258
Responses to Changep. 258
Politics of Changep. 259
Human Resource Managementp. 263
Recruiting and Selecting Staffp. 264
The Recruitment and Selection Processp. 265
Job Analysisp. 267
Recruitmentp. 268
Where to Lookp. 268
How to Look--Recruiting Sourcesp. 269
When to Lookp. 269
How to Sell the Organizationp. 269
Cross-Training as a Recruitment Strategyp. 270
Interviewingp. 270
Principles for Effective Interviewingp. 271
Developing Structured Interview Guidesp. 272
Involving Staff in the Interview Processp. 277
Interview Reliability and Validityp. 277
Education, Experience, Licensure, and Physical Examinationsp. 278
Integration of Informationp. 279
Legality in Hiringp. 279
Negligent Hiringp. 282
Allocating Staff Resourcep. 284
Staffing and Schedulingp. 285
Patient Classification Systemsp. 285
Determining Nursing Care Hoursp. 288
Determining FTEsp. 288
Determining Staffing Mixp. 289
Determining Distribution of Staffp. 289
Schedulingp. 291
Creative Staffing and Schedulingp. 291
Supplemental Staffp. 291
Turnoverp. 293
Measurement Issuesp. 294
Consequences of Turnoverp. 294
A Model of Employee Turnoverp. 295
Strategies for Controlling Turnoverp. 296
A Systems Perspectivep. 296
Performance Appraisalp. 300
A Model of Job Performancep. 301
Employee Motivationp. 301
Motivational Theoriesp. 301
Employee Abilityp. 307
Employee Performancep. 307
The Performance Appraisalp. 308
Evaluation Philosophyp. 309
Components to Be Evaluatedp. 310
Specific Evaluation Methodsp. 311
Potential Appraisal Problemsp. 313
The Appraiserp. 315
Documenting Performancep. 316
Diagnosing Performance Problemsp. 318
The Performance Appraisal Interviewp. 318
Preparing for the Interviewp. 318
The Interviewp. 320
Key Behaviors for an Appraisal Interviewp. 320
Improving Appraisal Accuracyp. 321
Appraiser Abilityp. 321
Appraiser Motivationp. 322
Rules of Thumbp. 322
Enhancing Employee Performancep. 325
Staff Developmentp. 326
Needs Assessmentp. 326
Planningp. 327
Implementationp. 330
Evaluationp. 333
Designing Staff Development Programs for a Multicultural Staffp. 334
Day-to-Day Coachingp. 335
Dealing with a Policy or Procedure Violationp. 336
Disciplining Employeesp. 337
Terminating Employeesp. 337
Managing Selected Personnel Problemsp. 340
Employees with Problemsp. 341
Overachievers or Super-Achieversp. 341
Disgruntled Employeesp. 341
Overstressed Employeesp. 341
The Employee with a Substance Abuse Problemp. 342
Absenteeismp. 346
A Model of Employee Attendancep. 346
Managing Employee Absenteeismp. 348
Absenteeism Policiesp. 349
A Systems Perspectivep. 350
Family and Medical Leavep. 350
Workplace Violencep. 351
Collective Bargainingp. 353
Federal Legal Structure for Labor-Management Relationsp. 354
Early Federal Regulations of Collective Bargainingp. 354
National Labor Relations Act (Wagner Act)p. 354
The Labor-Management Relations Act (Taft-Hartley Act)p. 355
Labor Management Reporting and Disclosure Actp. 356
Federal Sector Collective Bargainingp. 356
1974 Health Care Amendments to Taft-Hartleyp. 356
Process of Unionizationp. 357
Selection of a Bargaining Agentp. 357
Certification to Contractp. 358
Contract Administrationp. 358
Decertificationp. 358
The Nurse Manager's Rolep. 359
The Grievance Process: An Examplep. 359
Strikesp. 360
Major Issues in Collective Bargaining for Nursesp. 360
Unit Determinationp. 360
Labor-Management Committeesp. 361
Definition of Supervisorp. 362
Nurses, Unions, and Professional Associationsp. 362
Future of Collective Bargainingp. 364
Indexp. 367
Table of Contents provided by Syndetics. All Rights Reserved.


Leading and managing are essential skills for all nurses Lin today's rapidly changing health care arena. New graduates find themselves man grog unlicensed assistive personnel, and experienced nurses are managing groups of health care providers from a variety of disciplines and educational levels. Declining revenues and increasing costs mandate that every organization use its resources efficiently. Thus, nurses are challenged to manage effectively with fewer resources. Never has the information presented in this textbook been needed more.Effective Leadership & Management in Nursing,Sixth Edition, can help both student nurses and those with practice experience acquire the skills needed to ensure success in today's dynamic health care environment. FEATURES OF THE SIXTH EDITION Effective Leadership & Management in Nursinghas made a significant and lasting contribution to the education of nurses and nurse managers in its five previous editions. Used worldwide, this award-winning textbook is now offered in an updated and revised edition to reflect changes in the current health care system and in response to suggestions from the book's users. The Sixth Edition builds upon the work of previous contributors to provide the most up-to-date and comprehensive learning package for today's busy students and professionals. Student-Friendly Learning Tools Designed with the adult learner in mind, the book focuses on the application of the content presented with specific guidelines for implementing the skills included. To further illustrate and emphasize key points, each chapter in this edition includes these features: Chapter outline and preview NewMediaLinkboxes in each chapter introduce readers to resources and activities on the Companion Website at www.prenhall.com/sullivan-decker .MediaLinktabs in the chapter margins encourage students to use the website activities. Key terms defined on the pages where they first appear What You Know Nowlists at end of each chapter A list of "tools," or key behaviors, for using the skills presented in the chapter Case StudieswithManager's Checklistto demonstrate application of content Questions to Challenge Youto help-students relate concepts to their experience Up-to-date references

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